Exam 2: Special tests Flashcards
LLAF alignment
1) tibial torsion (sit, knee at 90. parallel to table. drill line thru malleoli. norm = 20-25% external)
2) prone figure 4. STJ neutral. ***thumb always medial and ankle 90 degrees
3) calcaneal-leg alignment
4) forefoot assessment. met heads, valgus/varus
5) assess first ray mvmnt compared to others.
Anterior Drawer test
- for ATF ligament. Lateral ankle sprains
- perform an anterior glide
- attend to reproduction of symptoms, end feel, amount of motion, PRS
Inversion stress test
- for AFT ligament. Lateral ankle sprains
- PROM inversion with PF
Talar tilt test
- for calcaneofibular ligament
- PROM of calcaneal carus
Calcaneal valgus (tilt)
- for deltoid ligament
- need to palpate over medial talus during to feel for displacement
External rotation stress test
- for syndesmosis (interosseous membran, ant/post tib-fibs)
- perform external rotation of foot relative to lower leg
Cotton test
- for syndesmosis (interosseous membran, ant/post tib-fibs)
- Stabilize lower leg and laterally translate talus by holding rearfoot.
Swing test
- for tibiotalar instability
- pt sit with knee at 90
- palpate anterior and posterior, medial and lateral. move pt thru knee flexion with bottom of foot parallel to floor at all times to cause PF/DF.
- resistance to DF and/or lack of bulge = post sublux or reduced post glide
- resis. to PF and/or lack of bulge = ant sublux or reduced ant glide
Thompson test
- for achilles rupture
- prone knee extended or flexed to 90 or tall kneeling
Dorsiflexion/Eversion test
- for tarsal tunnel syndrome
- Max DF + Eversion + MTP ext. hold for 5-10 seconds.
- positive test = intensification of numbness and or pain.
LaCrosse Test
- for retrocalcaneal bursitis
- Passive DF with knee flexed to 20 vs extended.
Achilles tendonitis = (+) if more painful with knee extended.
Bursitis = (+) if more pain when knee flexed
Heel thump test/calcaneal tap test
- for fractures
- thump applies to any bone and some ligaments.
- tap a distance from the painful area lightly and progress to thump. Looking for reproduction of pain.
- can also use tuning fork and stethoscope
Homan’s sign
- for DVT
- put pt in DF and squeeze calf
- Well’s prediction rule is preferred over this
Tinel’s sign
- for nerve irritation
- applies to any superficial nerve (know: tibial, common peroneal, post tib -med/lat plantar, deep peroneal in foot, and sural)
Peroneal tendon subluxation/dislocation
- resist eversion in a dorsiflexed position.
- will feel/hear a “pop” or see tendon shift
- knee bent
